You’ve probably been hearing (and reading) more and more about cord blood banking. More parents are taking advantage of this service as it becomes increasingly popular. You might be considering banking your baby’s cord blood, too, but you you probably have a ton of questions. I get it. Cord blood banking is a bit of an obscure business and I had a lot of questions, myself. It is important to make sure that you are asking the right questions when talking to different banks. You obviously want to choose the right cord blood bank for you and your family. I am listing all of the critical questions you will want to ask before you sign on the dotted line.
Product Quality
There are a few questions that you will want to ask to ensure you are getting a quality product for your time and money:
1. What is the recommended volume to be collected and what happens if I fail to collect the recommended minimum?
2. How many stem cells can I expect to store?
3. How do you freeze the cord blood?
Find out how they ensure that your cord blood is stored safely and monitored. What freezers do they use? Is the cord blood frozen in a separate freezer or mixed with other types of samples? Do they use liquid nitrogen or vapor nitrogen?
4. Is the cord blood stored in a single unit or is it compartmentalized?
For transplants, it is irrelevant because you want as many cells as possible so the entire unit of cord blood will be used. However, if scientific research advances and treatments and therapies are developed where only a small number of cells are needed, then having the cord blood stored in compartments could be advantageous because it will allow the cord blood to be used one portion at a time.
5. What processing technique is used?
Cord blood banking companies use a variety of patented processing methods to ensure the highest probability for success. Ask what type of processing the bank uses and why they believe it to be superior.
6. What types of tests are run on maternal blood?
You will want to know if any of these tests can provide justification for the samples to be rejected.
7. Do you test the stem cells for viability before storing? For example, testing for infectious diseases?
What happens if your child’s cord blood tests positive for one of these diseases?
8. Can your bank change storage facilities?
Find out if the bank reserves the right to change storage facilities. And if they do, what type of quality guarantee do you have regarding the new facility? How can you be assured that the cord blood will be transported safely from one facility to another?
9. Does your cord blood bank have clinical experience?
Ask the banks you’re considering how much of their customers’ cord blood has been used for transplants and other therapies. Experience releasing cord blood for transplants and participating in experimental therapies is an indication that the company is successful with clinical applications of cord blood. It confirms that the blood is being stored carefully enough for the stem cells to be viable when removed from the freezer.
Be wary of a bank that has lots of cord blood units in storage but has never used a unit for transplant. It could mean that doctors have rejected their cord blood–a warning that the bank’s procedures are not careful or thorough enough.
If the bank is new, you can’t expect it to have accumulated years of clinical experience. But it’s reassuring if the people operating the company have a proven track record.
10. What are your facility’s credentials? Does your bank meet federal, state, and accreditation requirements?
The cord blood bank you use must be accredited by the American Association of Blood Banks (AABB) to procure, process, and store umbilical cord blood stem cells used for transplantation. The AABB is the only accreditation that ensures high standards regarding quality of the processing and storage of your baby’s cord blood. Some banks are fee-paying members of the AABB, but that’s not the same as being fully accredited. To be accredited, the cord blood banking company must have its laboratory and administrative procedures reviewed, inspected, and validated regularly and their procedures must be compliant with the guidelines established by AABB for cord blood processing.
The cord blood bank’s methods and protocols should also be approved by the FDA, and they should be able to show all necessary state registrations and licenses.
11. Is the company committed to research for future applications of cord blood?
Look for a company that actively participates and invests in research and development of cord blood stem cell therapies. If a cord blood company is committed to research, it’s a good indication that the company is also committed to the future, which means they are more likely to have financial stability.
Product Safety
Ensuring the safety of both you and your cord blood or tissue is essential.
1. How does your company collect and store my child’s cord blood?
Look for a company that uses the Gravity Bag Collection method (vs. Syringe method). The Gravity Bag is the collection method preferred by doctors and is designed to collect the greatest volume of cord blood. It’s the industry standard method used by the majority of blood banks and is similar to the methods used by the American Red Cross and the National Institutes of Health. In addition, the closed tube/bag system eliminates exposure to airborne bacteria and greatly reduces likelihood of contamination during collection.
2. Where do you store the cord blood?
Find out exactly where the laboratory is and make sure it is within a safe distance from the delivery location to ensure a high probability of a successful transportation. You’ll also want to be sure that your cord blood bank has state-of-the-art facilities and provides maximum security and protection.
3. How is the umbilical cord collection kit delivered to the facility and where is it processed?
Ideally, you will be able to have the collection kit delivered by personal courier or overnight FedEx for greater distances. Cord blood and cord tissue should always be kept at room temperature.
4. Does your cord blood bank provide shipping with thermal integrity?
Shipping the cord blood to the laboratory is the crucial first step in safeguarding your baby’s stem cells. There are two ways that banks can protect the cord blood in transit. One approach commonly used for donated cord blood is to ship in a heavily insulated box. These containers have so much thermal protection that cord blood can be sent via FedEx. Priority shipping services like FedEx guarantee arrival time, but do not guarantee temperature conditions during transit.
The second approach, used by many family cord blood banks, is to ship in smaller boxes that have less thermal protection, but are carried by Life Sciences medical couriers. These couriers guarantee that boxes are kept in a passenger compartment where the temperature is in a safe range.
5. Is your collection kit FDA approved for c-sections (sterilized both inside and outside)?
Be sure the company you are looking at provides a sterile collection protocol to allow for collections to be performed during C-sections and emergency births.
6. Does the bank process cord blood within 48 hours?
Quick and proper transportation of the cord blood is crucial. Agencies that oversee cord blood transplants have set a limit of 48 hours on the time between birth and processing the cord blood for cryogenic storage. So you’ll want to make sure your bank processes cord blood within 48 hours after the birth.
Customer Experience
1. How will I be able to access my stem cells in the future?
Hopefully, you will never need to use your baby’s cord blood. However, should you need to use the stem cells from your stored cord blood, it is important that you feel confident in the process and system used by the cord blood bank to safely carry your stem cells to the correct location.
2. Will I be notified by the laboratory once the cord blood has been received, processed, and tested?
Find out if the laboratory will contact you or if you will be responsible for getting a hold of them. You will also want to know the final cell count.
Hidden Fees
Unfortunately, there can be hidden fees with some companies. Here are some questions to ask to ensure you aren’t blindsided:
1. What is the total cost of cord blood banking, including storage and all fees?
Be sure to get a full breakdown of every cost, including long-term storage (for 20 years or more). Sometimes a low price is shown upfront, but then hidden fees continue to add up over time. Be sure to find out if there are programs, discounts, promotions, and payment plans to accommodate your specific needs.
2. Are there any non-refundable fees should I need to cancel for any reason?
3. Is the annual storage fee fixed or might it increase later?
4. Does the lab HLA type the sample?
Before a transplant occurs, HLA typing is required to match the donor and patient. However, since HLA typing can cost several hundred dollars, there is no real reason to incur this cost until a transplant is needed. Find out if the bank insists on HLA typing the sample prior to the need of a transplant, and if so, what the fees are for this service.
5. Are there any additional processing fees upon withdrawal?
Trust
1. How long has your company has been preserving cord blood?
2. Do you have customer reviews that you can share with me?
2. Is your bank financially stable and profitable?
Cord blood banking is a business, and businesses do go bankrupt. Fortunately, if a cord blood bank goes out of business, another company invariably takes over the frozen inventory. While it is reassuring that you’re unlikely to lose your child’s cord blood, it’s not desirable to have it moved from one lab to another–and, worse, to wonder whether it was maintained properly in the waning days of the failed company.
3. Do you have an insurance plan or partnerships with other companies to cover inventory in the event of a natural disaster or business failure?
You should also find out if the company is a division of larger corporation, and whether there are academic affiliations, research collaborations, and equity partnerships with major biotechnology companies. This would provide proof that the company is committed to researching and developing further applications for cord blood stem cell therapy and will most likely be around for the long run.
